Partnering to Enable Active Rural Living: Pearl Project*

Article excerpt

ABSTRACT

Rural residents in communities face opportunities and obstacles for physical activity (PA), health, and well- being that differ from those experienced in non-rural settings. Yet, rural people's interpretations of PA and experience of the PA environment are understudied. This study utilized a descriptive case study approach in three rural New Hampshire communities and engaged rural residents in community participatory action research of the experiential factors that enable or prevent PA for adults and youth in their communities. Qualitative data were collected using photo mapping surveys, participant observations, interviews, and focus groups; analyzed using a constant comparative method and triangulated across multiple sources. Themes emerged and were organized into an ecologically grounded "People and Places" framework. Results depicted how attributes of people and place interact to explain PA habits and conditions in these rural communities, and generated resident-informed recommendations for designing programs, modifying environments, and enacting policies to advance active lifestyle supports.

For well over a decade, efforts have been aimed toward understanding the conditions unique to rural residency that shape human health and health outcomes among rural populations (Gamm and Hutchison 2010; Merchant, Coussens, and Gilbert 2006; Ricketts 1999). Rural areas, as defined by the U.S. Department of Agriculture (USDA), are all territory, population, and housing units located outside urbanized areas and an urban cluster (John 2008). A growing body of research is documenting the rise in obesity and obesity related behaviors (poor dietary habits and physical inactivity) in rural communities (Blankenau 2009). Rural residents often have a higher obesity and hypokinetic disease risk profile than the public and rural adults are often less physically active than adults in urban zones (Patterson et al. 2004). Many risk factors, including rural residency, have been associated with children being overweight or obese (Davis et al. 2011; Lutfiyya et al. 2007; Veugelers and Fitzgerald 2005). Davis and others (2011), using data from the 2003- 2004 and 2005-2006 National Nutrition and Health Examination Survey, found that obesity rates were higher in rural children than urban children. They additionally found that for children, meeting physical activity recommendations was obesity protective while engaging in more than two hours per day of sedentary electronic entertainment was obesity promoting (Davis et al. 2011). Accordingly, if public health efforts to address and prevent obesity among children and adults are to be effective, rural places are important settings and rural people important audiences for actions that promote physical activity and enable healthy, active lifestyles.

Physical activity research often focuses on individual factors and person-level behaviors. Rural residents encounter opportunities, as well as challenges, for meeting physical activity recommendations that are different from those found in urban and suburban settings. Natural rural landscapes may support outdoor and seasonal activities such as hiking, camping, canoeing, fishing, skiing, and snowshoeing. Maintaining rural residences and properties may enable physical activity through household chores, such as chopping wood, shoveling snow, clearing brush, maintaining gardens, and tending animals; rural occupations, such as forestry, agriculture, and even adventure programming may contribute to work- related physical activity when compared with office employment. On the other hand, rural communities may have extreme weather and geographic features, few or no sidewalks and bike lanes, and fewer amenities (e.g., playgrounds and schools) within walking and/or bicycling distance, which makes active transportation and recreation less convenient, unsafe, or even impossible for rural residents (Popkin, Duffy, and Gordon-Larsen 2005) and hinders unplanned physical activity for youth and families (Walia and Leipert 2012). …